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Do Cholesterol-Lowering Foods Really Work?

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As you cruise the supermarket aisles, or flip through TV channels, you'll find a barrage of food items - and even a new orange juice - that claim to be able to lower your cholesterol.

But are they good medicine - or just good marketing?

A little bit of both, said ABCNEWS' Medical Editor Dr. Tim Johnson. Some of the new foods contain substances called plant sterols, which studies have shown can reduce cholesterol levels by about 10 percent.

"We have known about plant sterols since the 1950s, but it is an only in the last 10 years that we have learned how to put them in the foods without changing taste or texture," Johnson said. "Since they are a chemical cousin of cholesterol they block the absorption of real cholesterol in our intestines, and therefore modestly lower the levels of bad cholesterol in all blood."

Plant sterols are present naturally, but in small quantities, in many fruits, vegetables, nuts, seeds, cereals, legumes, vegetable oils, and other plant sources.

The new products contain plant sterols as additives. While doctors say the the cholesterol-busting foods can certainly help those with moderately high cholesterol levels, those with high-risk cholesterol levels, above 240, should turn to prescription drugs - namely, statins.

"Plant sterols are not anywhere close to the cholesterol-lowering potency of the statin medications," said Dr. Peter Schulman, an associate professor at the University of Connecticut School of Medicine in Farmington, Conn. "The newest drugs lower the bad cholesterol by close to 50 at the starting dose. Sterols lower cholesterol by approximately 10 percent."

Nonetheless, anything that lowers cholesterol safely is a good thing, he said.

The products that boast cholesterol-lowering abilities include spreads and margarines, such as Benecol, Take Control and Smart Balance, and soy snacks such as GeniSoy Crisps. Minute Maid Premium Heart Wise orange juice, to be released in November, is the first orange juice to contain plant sterols.

Manufacturers have a sizable audience to target. An estimated 105 million American adults have total blood cholesterol values of 200 mgdL and higher, and of these about 42 million American adults have levels of 240 or above, according to the American Heart Association. In adults, total cholesterol levels of 240 or higher are considered high risk. Levels from 200 to 239 are considered borderline-high risk.

Check the Labels

When you look at the label, look for the words "plant sterols," on the ingredient list, Johnson said. The label should also tell you how many grams of plant sterols can be found in each serving or pill.

According to a report from the National Cholesterol Education Program in Bethesda, Md, plant-derived sterols can lower LDL cholesterol levels by 6 to 15 percent, and the maximum benefit comes from consuming about two grams of cholesterol per day.

But keep an eye on the calories, Johnson says. If you are getting too many calories from the sterol-containing products you end up offsetting the benefits of the sterols. Because they can only lower cholesterol by about 10 percent, the plant sterols make the most substantial difference for the 100 million Americans who have borderline high cholesterol, with levels between 200 and 239.

However, even if you have a cholesterol level that is higher than 240, and require dug therapy, the new sterol-containing foods can help you further reduce your cholesterol levels, Johnson said.

In addition to watching the calories in plant sterol-containing products, there are other impacts.

"There is some evidence that these plant sterols can reduce the absorption of certain vitamins like vitamin A and E which may interfere with the prevention of heart disease often attributed to these vitamins," Johnson said. "Some say if you use products with plant sterols you should also take a vitamin supplement." Cholest-off, a supplement taken as a pill has one gram of plant sterols, so those who are trying to reduce cholesterol are advised to take two a day.

Another new product called GeniSoy Crisps are made of soy, and manufacturers say it can also help reduce cholesterol. Many studies have shown the healthful effects of soy, so these may be beneficial as well, Johnson said.

With all of the products on the market, there is a risk that some people who get screened at a health fair and find out they have high cholesterol may simply start stocking up on cholesterol-cutting foods and avoid going to the doctor, Schulman said. That can be a risky course of action.

"There are other conditions that may cause elevated cholesterol such as diabetes, underactive thyroid, excessive alcohol consumption," he said. "Treating those conditions may eliminate any need to take cholesterol-lowering medications. Not treating them may result in premature death or disability."

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